A System for the Analysis of Snore Signals

AbstractSleep apnoea syndrome (SAS) is a disease consisting in the nocturnal cessation of oronasal airflow at least 10 seconds in duration. The standard method for SAS diagnosis is the polysomnographic exam (PSG). However it does not permit a mass screening because it has high cost and requires long term monitoring.This paper presents a preliminary software system prototype for snoring signal analysis, whose main goal is to support the doctor in SAS diagnosis and patient follow-up. The design of the system is modular to allow a future hardware implementation in a portable device for personal snore collection and monitoring

Children with Sleep-Disordered Breathing and the Role of Attention in Executive Functioning Deficits

This item is only available electronically.Sleep-disordered breathing (SDB) is a common disorder found in children, with up to a third of children affected. SDB ranges from acute snoring to Obstructive Sleep Apnea (OSA), characterised by partial or complete cessation of airflow in the upper airway during sleep. Neurocognitive deficits as a result of SDB in children have been extensively examined, particularly in relation to executive functioning. However, these findings are inconsistent and it is possible that underlying attentional deficits in SDB are the cause of reported executive dysfunction, rather than these being a direct result of SDB. Using previously collected data, this study’s focus is on whether attentional deficits play an underlying role in producing executive dysfunction. In the present study, children with SDB (18 males, 12 females, mean age, 8.30 ± 2.46 in years) and healthy matched control children (19 males, 21 females, mean age, 8.26 ± 2.15 in years) completed a battery of executive and attention tasks, as well as overnight monitoring of sleep. Despite deficits in planning ability and overall attention/executive performance amongst SDB children, there was no interaction between group and task (attention vs executive functioning), indicating that deficits in executive function are not likely the result of underlying attention problems. BMI z-score was a significant predictor of planning deficiency, alongside IQ to a lesser extent. This study offers a new perspective in the current conversation by expanding upon underlying mechanisms in children with SDB, and a deeper understanding on the individual characteristics that play a role in executive functioning deficits.Thesis (B.PsychSc(Hons)) -- University of Adelaide, School of Psychology, 202

Snoring in Early Childhood

Taustaa: Unenaikaiset hengityshäiriöt, jotka käsittävät sekä kuorsauksen että obstruktiivisen uniapnean, ovat lapsilla varsin yleisiä, joskin raportoidut esiintyvyydet vaihtelevat suuresti. Vaikka kuorsaus on obstruktiivista uniapneaa lievempi unenaikainen hengityshäiriö, myös siihen on osoitettu liittyvän lisääntynyt riski kohonneeseen verenpaineeseen, neurokognitiivisiin ja käyttäytymisongelmiin sekä haitallisiin muutoksiin lasten aineenvaihdunnan mittareissa. Imeväisten ja taaperoiden unenaikaisia hengityshäiriöitä koskeva tutkimustieto on rajallista verrattuna kouluikäisiin lapsiin. Tavoitteet: Tässä etenevässä tutkimuksessa tarkasteltiin kuorsauksen esiintyvyyttä imeväisiässä, sekä kuorsaukseen liittyviä riskitekijöitä ennen ja jälkeen syntymän. Lisäksi tavoitteena oli arvioida kuorsauksen esiintyvyyttä ja pysyvyyttä kahden ensimmäisen elinvuoden aikana kahdessa suomalaisessa syntymäkohortissa. Tutkimuksessa tarkasteltiin myös varhaislapsuuden kuorsauksen ja kasvun välistä yhteyttä sekä sydän- ja verisuonisairauksien ja aineenvaihduntahäiriöiden riskitekijöitä verinäytteiden avulla. Menetelmät: Ensimmäinen tutkimusväestö koostui 1388 imeväisestä, jotka rekrytoitiin CHILD SLEEP (CS) -syntymäkohortista Pirkanmaan sairaanhoitopiirissä vuosina 2011–2013. Vanhemmille osoitetut kyselyt täytettiin ennen lapsen syntymää sekä lapsen ollessa kolmen ja kahdeksan kuukauden ikäinen. Toinen tutkimusaineisto sisälsi 947 lasta CS-kohortista sekä 1393 lasta FinnBrain (FB) -syntymäkohortista. Molemmat vanhemmat täyttivät kyselylomakkeet lapsen ollessa 24 kuukauden ikäinen, jotka sisälsivät osiot lapsen unesta sekä ympäristötekijöistä. Kolmas tutkimusjoukko koostui 78 lapsesta CS-kohortista, joille tehtiin yhden yön polysomnografiatutkimus (PSG), ja joiden vanhemmat olivat täyttäneet uni- ja ympäristötekijöitä koskevan kyselylomakkeen 24 kuukauden kohdalla. Kasvutiedot kerättiin neuvoloista, ja aineenvaihduntaverinäytteet otetiin 31 lapselta. Tulokset: Tutkimuksen mukaan vauvojen kuorsauksen esiintyvyys oli 3,2 % kolmen kuukauden iässä ja 3,0 % kahdeksan kuukauden iässä. Imeväisiällä kuorsaavilla lapsilla oli enemmän univaikeuksia. Lisäksi kolmen kuukauden iässä kuorsaavien vauvojen uni oli levottomampaa ja kestoltaan lyhyempää kuin muilla lapsilla. Vauvojen kuorsauksen riskitekijöitä olivat äidin tupakointi sekä vanhempien kuorsaus. Lisäksi korvikeruokinta ja tutinkäyttö lisäsivät vauvan kuorsauksen riskiä kolmen kuukauden iässä. Kuorsauksen yhdistetty esiintyvyys kahdessa syntymäkohortissa 24 kuukauden iässä havaittiin olevan 2,3 %, joka on merkittävästi vähäisempi kuin aiemmissa tutkimuksissa on raportoitu. Lasten, joilla oli toistuvia infektioita tai diagnosoitu astma, kuorsasivat muita todennäköisemmin säännöllisesti. Lisäksi riski lapsen kuorsaamisesta kasvoi tavallisesti, jos molemmat vanhemmat kuorsasivat joka yö. Lapsen kuorsauksen havaittiin liittyvän myös äidin alhaisempaan koulutustasoon ja alhaisempiin kuukausituloihin. Kahden ensimmäisen elinvuoden aikana kuorsanneiden lasten ja kontrolliryhmän kasvussa ei havaittu merkittäviä eroja. Kuitenkin lapsien, joiden PSG:n rekisteröimä kuorsausaika oli jakauman ylimmässä neljänneksessä, HDL-arvot olivat alhaisemmat verrattuna lapsiin, joiden kuorsausaika oli alimmassa neljännessä. Lineaariset regressiomallit paljastivat, että kuorsausaika ennusti merkittävästi alhaisempia HDL- ja ApoA1-tasoja sekä korkeampia hs-CRP-tasoja. Johtopäätökset: Yhteenvetona voidaan todeta, että säännöllisen kuorsauksen esiintyvyys suomalaisissa syntymäkohorteissa oli aiemmin raportoitua pienempi. Tässä tutkimuksessa havaittiin, että vanhempien kuorsaus ja äitien tupakointi olivat kuorsauksen riskitekijöitä vauvaiässä, ja kuorsaavilla vauvoilla oli myös enemmän univaikeuksia. Riskitekijöitä kuorsaukselle kaksivuotiaana olivat vanhempien kuorsaus, äidin alhaiset tulot sekä alhainen koulutustaso. Suomalaisilla lapsilla PSG- tutkimuksessa rekisteröity kuorsausaika liittyi negatiivisiin muutoksiin seerumin metabolisissa merkkiainetasoissa. Nämä havainnot viittaavat siihen, että kuorsaus varhaislapsuudessa voi lisätä sydän- ja verisuonisairauksien riskiä aikuisiässä.Background: Sleep disordered breathing (SDB) includes snoring and obstructive sleep apnea (OSA) and is common in children, with reported prevalence rates varying widely. Snoring, though less severe than OSA, can have detrimental effects on children’s health. Left untreated. it can lead to elevated blood pressure, neurocognitive and behavioral problems, and adverse impacts on metabolic profiles. Research on infants’ and toddlers’ SDB is limited compared to data on snoring in school-aged children. Objectives: This prospective study examined the prevalence of snoring during early childhood and the prenatal and postnatal risk factors for this condition. A further aim was to evaluate the prevalence and persistence of snoring during the first two years of life in two Finnish birth cohorts. Additionally, the association between snoring and growth during early childhood and the risk factors for cardiovascular and metabolic disorders, as measured by blood samples at age two, was examined. Methods: The first study population consisted of 1388 infants who were recruited from the CHILD SLEEP (CS) birth cohort in the Pirkanmaa Hospital District, Finland between 2011 and 2013. Parents completed questionnaires on sleep and background factors prenatally, as well as when the infants were three and eight months old. The second study included 947 children from the CS and 1393 children from the FinnBrain (FB) birth cohorts. At 24 months of age, both parents were given questionnaires that included sections on the child’s sleep and environmental factors. The third sample consisted of 78 children from the CS cohort who underwent full-night polysomnography (PSG) and whose parents completed a questionnaire on sleep and environmental factors at 24 months. Growth charts were obtained from well-baby clinics, and metabolic blood samples were taken from 31 children. Results: According to the study, the prevalence of habitual snoring in infants was 3.2% at three months and 3.0% at eight months. Infants who snored at these ages experienced more sleeping difficulties. At three months, snoring infants had shorter sleep duration and more restless sleep than other infants. The risk factors for infants’ snoring were maternal smoking and parental snoring. Additionally, formula feeding, and pacifier use added to the risk of an infant’s snoring at the age of three months. The combined prevalence of habitual snoring in two birth cohorts at the age of 24 months was found to be 2.3%, which is significantly lower than that reported in previous studies. Children who experienced recurrent infections or asthma were found to be more likely to snore habitually. Moreover, the risk of a child snoring habitually increased when both parents snored every night. A child’s likelihood of habitual snoring was found to be associated with a mother with lower level of education and a lower monthly income. During the first two years of life, there were no significant differences in growth parameters between the children who snored and the control group. However, children whose total sleep snoring time recorded by PSG was in the highest quartile had lower levels of high-density lipoprotein (HDL) compared to those in the lowest quartile. Linear regression models revealed that snoring time significantly predicted lower HDL and apolipoprotein A1 (ApoA1) levels and higher levels of high- sensitivity C-reactive protein (hs-CRP). Conclusions: In conclusion, the prevalence of habitual snoring in the Finnish birth cohort was lower than previously reported. Parental snoring, maternal smoking, and socioeconomic factors were linked to infant snoring. Snoring infants were reported to face more sleep difficulties, and independent risk factors included parental snoring, low maternal income, and low maternal education levels. In Finnish children, snoring was associated with adverse effects on the serum metabolic profile. These findings suggest that snoring during early childhood may increase the risk of cardiovascular disease in adulthood

Novel Measurements of Cough and Breathing Abnormalities during Sleep in Cystic Fibrosis

This Doctor of Philosophy thesis describes cystic fibrosis (CF), sleep parameters and novel measurement techniques to determine the effect of lung disease on sleep using non-invasive techniques. Cystic Fibrosis (CF) is characterised by lungs that are normal at birth, but as lung disease progresses with age, adults with CF can develop sleep abnormalities including alteration in sleep architecture and sleep disordered breathing. This thesis seeks to investigate simple non-invasive measures which can detect abnormalities of sleep and breathing in CF adults. The identification of respiratory sounds (normal lung sounds, coughs, crackles, wheezes and snores) will be examined using the non-invasive sleep and breathing measurement device, the Sonomat. The characterisation of these respiratory sounds will be based on spectrographic and audio analysis of the Sonomat. Cross-sectional and longitudinal analysis of adults with CF using polysomnography and the Sonomat will further assess objective sleep and breathing abnormalities. Additional to the examination of objective measurements of sleep, subjective evaluation using CF-specific and sleep-specific questionnaires will assess subjective sleep quality and QoL in adults with CF

A preliminary exploration of the construct validity of the Berlin questionnaire as a measure of obstructive sleep apnoea in a South African population : a clinical health psychology perspective.

Thesis (M.Soc.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2006.Clinical professionals in South Africa are generally unaware of the impact of obstructive sleep apnoea (OS A). The cost to the state of untreated apnoea may be extremely high. In primary health care encounters OSA often goes undiagnosed. The cascade of symptoms linked to OSA is profound, placing patients at risk for debilitating problems impacting on self and others. The aim of this study was to validate a questionnaire, which could be used at a primary health care level to identify patients with OSA thus cutting costs and improving efficient, effective and ethical service to patients. The Berlin Questionnaire (BQ) (Netzer et al. 1999) was administered to a clinical sample of consenting patients at a private sleep laboratory in Durban, South Africa (N = 119)(completed n = 110). Home-based sleep studies (n = 116) on a portable cardio-respiratory screening device were also obtained for objective comparison. From the results obtained in this South African sample, the BQ showed low validity and reliability (Cronbach a = 0.62 - 0.84) to individual items of the BQ. The total BQ score and high-risk symptom category analysis showed mildly significant correlations with internationally approved protocols. The BQ identified 60% of the high-risk group (AHI >5). Furthermore, risk categories were useful in predicting AHI ratings in 64% of moderate OSA cases and 25% of severe OSA cases. The BQ therefore has useful psychometric properties as an adjunct assessment tool to screen for high-risk OSA cases where resources are scant. Clinical health psychologists are in an ideal position to recognise the risk factors and symptoms of OSA. The clinical assessment and the value of the correct diagnosis will alleviate the treatment of psychological symptoms at a superficial level in primary health care facilities

Sleep disordered breathing and its treatment in children

The establishment of a dedicated paediatric sleep unit over the past three years has allowed detailed investigation of a large number of children with sleep associated upper airway obstruction. This thesis explores the characteristics of upper airway obstruction and sleep associated breathing control abnormalities, in children who have been investigated in that unit. The "unit" began with three or four people performing children’s sleep studies at the Sleep Unit (for adults) at RPAH; the results presented here include those studies. The methods used in this thesis have evolved through practical experience acquired in caring for children with breathing disorders in sleep. This thesis is presented in two parts. The studies in the first section provide an overview of the presentation and treatment of the syndrome of obstructive sleep apnoea (OSA) as it occurs in infants and children. The second section is a more detailed exploration of OSA and its treatment in achondroplasia. These latter studies provide further insights into the disorder in this specific group, and therefore into some aspects of OSA in the broader population of children

Predicting Alzheimer's disease CSF core biomarkers: a multimodal Machine Learning approach

IntroductionAlzheimer's disease (AD) is a progressive neurodegenerative disorder. Current core cerebrospinal fluid (CSF) AD biomarkers, widely employed for diagnosis, require a lumbar puncture to be performed, making them impractical as screening tools. Considering the role of sleep disturbances in AD, recent research suggests quantitative sleep electroencephalography features as potential non-invasive biomarkers of AD pathology. However, quantitative analysis of comprehensive polysomnography (PSG) signals remains relatively understudied. PSG is a non-invasive test enabling qualitative and quantitative analysis of a wide range of parameters, offering additional insights alongside other biomarkers. Machine Learning (ML) gained interest for its ability to discern intricate patterns within complex datasets, offering promise in AD neuropathology detection. Therefore, this study aims to evaluate the effectiveness of a multimodal ML approach in predicting core AD CSF biomarkers.MethodsMild-moderate AD patients were prospectively recruited for PSG, followed by testing of CSF and blood samples for biomarkers. PSG signals underwent preprocessing to extract non-linear, time domain and frequency domain statistics quantitative features. Multiple ML algorithms were trained using four subsets of input features: clinical variables (CLINVAR), conventional PSG parameters (SLEEPVAR), quantitative PSG signal features (PSGVAR) and a combination of all subsets (ALL). Cross-validation techniques were employed to evaluate model performance and ensure generalizability. Regression models were developed to determine the most effective variable combinations for explaining variance in the biomarkers.ResultsOn 49 subjects, Gradient Boosting Regressors achieved the best results in estimating biomarkers levels, using different loss functions for each biomarker: least absolute deviation (LAD) for the Aβ42, least squares (LS) for p-tau and Huber for t-tau. The ALL subset demonstrated the lowest training errors for all three biomarkers, albeit with varying test performance. Specifically, the SLEEPVAR subset yielded the best test performance in predicting Aβ42, while the ALL subset most accurately predicted p-tau and t-tau due to the lowest test errors.ConclusionsMultimodal ML can help predict the outcome of CSF biomarkers in early AD by utilizing non-invasive and economically feasible variables. The integration of computational models into medical practice offers a promising tool for the screening of patients at risk of AD, potentially guiding clinical decisions

Sleep homeostasis in the European jackdaw (<i>Coloeus monedula</i>):Sleep deprivation increases NREM sleep time and EEG power while reducing hemispheric asymmetry

Introduction: Sleep is a wide-spread phenomenon that is thought to occur in all animals. Yet, the function of it remains an enigma. Conducting sleep experiments in different species may shed light on the evolution and functions of sleep. Therefore, we studied sleep architecture and sleep homeostatic responses to sleep deprivation in the European jackdaw (Coloeus monedula).Methods: A total of nine young adult birds were implanted with epidural electrodes and equipped with miniature data loggers for recording movement activity (accelerometery) and electroencephalogram (EEG). Individually-housed jackdaws were recorded under controlled conditions with a 12:12-h light-dark cycle.Results: During baseline, the birds spent on average 48.5% of the time asleep (39.8% non-rapid eye movement (NREM) sleep and 8.7% rapid eye movement (REM) sleep). Most of the sleep occurred during the dark phase (dark phase: 75.3% NREM sleep and 17.2% REM sleep; light phase 4.3% NREM sleep and 0.1% REM sleep). After sleep deprivation of 4 and 8 h starting at lights off, the birds showed a dose-dependent increase in NREM sleep time. Also, NREM sleep EEG power in the 1.5–3 Hz frequency range, which is considered to be a marker of sleep homeostasis in mammals, was significantly increased for 1-2 h after both 4SD and 8SD. While there was little true unihemispheric sleep in the Jackdaws, there was a certain degree of hemispheric asymmetry in NREM sleep EEG power during baseline, which reduced after sleep deprivation in a dose-dependent manner.Conclusion: In conclusion, jackdaws display homeostatic regulation of NREM sleep and sleep pressure promotes coherence in EEG power